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Author
Topic: A brief oral encounter that has led to PEP (Read 5996 times)

Thank you to all of the great moderators on this forum for helping worry worts like myself and others as we assess our risks.

Here is my story:

I've always had an intense fear of HIV. I have a diagnosed Generalized Anxiety and Panic Disorder as it is, with some manifestations of OCD within that. I have a therapist and have worked on those issues in the past.

I am a young guy in his mid-20's and I have been sexually active. I live in NYC and spend time abroad, too, so I am aware of the risks. I have been a sex educator myself. In the past I have always practiced protected anal sex and unprotected oral sex. Before an encounter, whether or not someone lies to me, I always ask my partners their status and when their last test was.

On January 1 I had a condom break with a straight guy. This man had just broken up with his girlfriend of five years. A mutual friend. He was inside of me for about 5 seconds and we stopped with no exchange of fluids. I am American but was in London and inquired at the Accident and Emergency about PEP. They told me I was more at risk from PEP side-effects than HIV, and to test again within the proper periods of time for a negative test. Reluctantly I decided not to do PEP and ended up testing negative via an HIV DUO test at 29 days post-exposure in January, and again negative with a rapid-prick on May 2 and May 3rd.

That was a traumatic experience for me and in the meantime I have decided to only have oral sex. I usually am the insertive partner (I get blown) and have only gave head since my last test to one guy, who I had a lengthy conversation with about the importance of testing and not exchanging fluids, etc.

Unfortunately on April 30/May 1 (midnight or so) I was at a gay bar and was in the toilet urinating when a man came to perform oral sex on me. I was drunk, but it was just some kissing and very brief oral sex. Immediately after, I asked him his status and he told me he was Poz undetectable. I was stunned but continued chatting at the bar and we exchanged contact information for email. He has been poz since the 80's, sees his doc, takes his meds. Undetectable for 10 years.

While I am aware of the risks, the next day I went to a clinic specializing in LGBT issues and HIV about PEP. The nurse told me the chances were very low and it would be overkill; plus I did not qualify for their program fee (I have no insurance as I am a student about to graduate) and I'd have to pay it out of pocket. I went for an HIV test with a counselor who then attempted to discourage me from taking any sorts of PEP, ultimately relaying to me the notion that I THINK I haven't been with poz guys in the past, but most likely have considering I'm in NYC.

A friend of a friend is an infectious disease HIV specialist. I called him up and he said it's 1 in a million and would highly suggest against me going on PEP. He told me he 100% protested it and that other people need the resources. Still, I suffer with massive hypochondria. That being said, I went on PEP about 36-37 hours after exposure. I was started on Zidovudine and Truvada for the first five days, before switching to Viread, Zidovudine, and Lamivudine. The Zidovudine (AZT) immediately had bad effects on me, and I was vomiting at the toilet for 2 days straight. It is Day 10 and I have no real side effects from the Viread and Lamivudine.

I know this sounds insane, but I am worried to stop the PEP in case in the future I become positive and drug resistance. I have contacted my therapist who immediately advised me to get in touch with a psychiatrist to handle my anxiety. So I am definitely working with all the resources I have here. The doctor who prescribed me the PEP is irritated with me, and I feel bad asking him questions. In the meantime, I've been perusing the internet (bad) to find out about situations like mine. I guess my worry is that more happened in the bathroom I don't remember (though I definitely am almost 100% sure I had no anal sex of any sorts-- it's the anxiety that is making me double guess EVERYTHING, including all previous encounters) and the guy told me it was just what I thought it was.

My questions:

1) Do you think Viread and Lamivudine are adequate for PEP? No side effects, as mentioned.2) I really am in a funk because of this. I feel depressed and anxious and like the chances are 50/50 rather than 0.01 in however many thousands.

Besides what I expect to be many angry people that I'm on these medications, what do you think my chances are now? I had a gonorrhea, chlamydia, syphilis testing the day after my exposure and the results are all negative. I have no visibile sores or cuts on my penis and my poz friend practices adequate oral hygiene (he says).

The doctor is testing me with a rapid about 16 days post-PEP and with a viral load test too. Given this situation, does that sound definitive? (I know about the 12-13 week window too).

I guess I am worried he is lying about his undetectable level. I also get the results of my viral load test that they take at beginning of PEP in case I already had an infection (though I have only had oral encounters since my negative test with the condom break in January-- 3 times I got a BJ and once I gave a BJ with a rim job). All of this is quite stressful and makes me feel like my life is over. I don't mean to lessen anyone else's experiences, but I would truly appreciate words of wisdom or kind advice.

Ironically, a friend of mine said: "You're willing to trust a guy who says he's neg you met on Grindr but not an infectious disease specialist in HIV in NYC who told you you don't need drugs?"

Thanks for your response. Maybe you could clarify something for me? What does an "exposure" actually entail? Does an "exposure" mean someone negative engages in a sexual act with someone positive and has a risk just for that fact, or is an exposure when an exchange of fluids required for transmission take place between a positive and a negative person?

That being said, did I have an exposure? If there was any exchange of blood (unlikely), do you think my PEP would counteract that dramatically? I am wondering if there are any ballpark statistics anyone can throw at me about my risk + my PEP to equal my chances.

Thanks for your help, and apologies for being another nutty person stressing on these forums.

What does an "exposure" actually entail? Does an "exposure" mean someone negative engages in a sexual act with someone positive and has a risk just for that fact, or is an exposure when an exchange of fluids required for transmission take place between a positive and a negative person?

That being said, did I have an exposure?

An exposure in the context of your case is did you have unprotected sex that could put you at risk for HIV . When we do risk assessments we always assume the other person is HIV positive and infectious . You did not have a risk , so no possible exposure took place .

Im going to stress the fact on more time , we cant help you here . You have been told by everyone you have asked that you are worrying needlessly so I cant expect for you to except my statements when I address your concerns .

This is not about HIV , its about your mental health and I think you are better served if you stick with your psychiatrist to get though this .

Exposure = when cells in your body are exposed to viable viral particles that can infect them.

You had no exposure. A person briefly sucked your penis at a urinal. Saliva is not infectious. As a matter of fact, it contains over a dozen elements that neutralize HIV. No one in the history if the pandemic has been infected through receiving oral sex. You are wasting your energy, time, and as your doctor pointed out, resources by taking unnecessary pep.

I certainly hope you plan to discuss this with your therapist. This is not an HIV situation and frankly I don't see what more we can offer you.

HIV is transmitted sexually by unprotected anal and vaginal sex. That is all.

Logged

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

So far I have been cleared of all STI's thus far and received a negative viral load test from my encounters before this incident. I hadn't had any partners for 3 weeks beforehand, so it's a good indicator.

While the next day I was pretty sure what happened, my anxiety keeps making me think perhaps we had full blown unprotected sex in the bathroom. I am pretty sure I would have felt that the next morning. Also, we spent a while chatting at the bar after our encounter too. I think we would have gotten kicked out if we'd been screwing in public. This was a bar, not a sex club. I just remember him going down on me, then not a whole lot except it being brief, and then bringing him from his knees to his feet, asking his status, and chatting at the bar. He mentioned to me over e-mail he has regular check ups and is a very safe "slut" and usually gets off just by giving head. He also mentioned from our contact I really had no chances, he is educated about his disease, and has been taking care of himself since the mid-80's. He said if I really want PEP I should come over and we can finish the BJ. Wry humor... Yet, the mind is a powerful thing and I wonder if something else had occurred.

Do the forum moderators ever see postings from people who second guess their encounters? I can guarantee (absolutely naively, I know) that if he had said negative, I would have left it at that with the bj scenario and never thought twice about potential anal sex. Even drunk off my rocker, I never engage in anal sex unprotected, especially in a public place with a stranger. My mind is playing tricks on itself.

Allergy season is also beginning so I am feeling a bit down (headache) combined with my Viread and Lamivudine PEP. It's been two weeks so naturally I am worried about ARS. I haven't had many side effects from these drugs except fatigue and have 2 weeks left on them, which I plan to continue.

Final question: my PEP program tests me at 2 weeks post-PEP with a rapid and a viral load. They claim the viral load is conclusive. I know guidelines are more conservative (3 to 6 months out), but what you guys say that a neg viral load 2 weeks post pep for my exposure would be conclusive? I am not being sexually active at all right now because I am working through these issues with my therapist and psychiatrist. I am planning a trip abroad from the end of June to September and am worried I won't be able to plan it in case I do test positive, etc.

Let me just defend myself to those who think I am a total hypo nut (and this is from the viewpoint of a younger person, not someone claiming to have an inkling of an idea what it was actually like to be around during the early days): I grew up around gay folks in the late 80's and early 90's. I am also a young gay man navigating sex and life in New York. My entire life I've heard about HIV/AIDS and the devastation it has caused... I think it's quite difficult as a young man in your 20's to parcel out the part of your gay identity that is also linked to HIV through social conditioning. Many of us group up thinking gay = AIDS, or at least we heard those messages in the media. This issue of stigma is what ignites so much fear and paranoia. It's a hard psychological bridge to cross. To the long term survivors and those just living everyday with this illness, I admire and envy your courage more than I could ever say.

I just hope I haven't made an irreversible mistake for my own life when I already knew so much about prevention in the first place. I am going to re-think how I even approach casual sex and try to continue this conversation with my peers, who, I assure you, accept a negative answer as a negative answer and go to town without protection pretty regularly. And here I was thinking I was Pollyanna. I also hope I can come to have a healthy sex life in the future.

Let me end by paraphrasing what my shrink said to me recently about all of this: it's self-indulgent bullsh*t about other issues in my life. Harsh words, harder to get across a hypo/anxiety-ridden mind.

Any thoughts from Ann or Andy or anyone else are much welcomed and appreciated. This is my last free post.

Do we see messages from people second guessing encounters? Any thread with more than one reply is a "yes," so abundantly yes.

Your risk, from what I understand, was getting your penis sucked by a positive person.

Which by no stretch of the imagination is a risk.

Drunk off your rocker, it's doubtful that you COULD have penetrated the guy, even if there had been room. Which, being a guy and having some urinal experience, you did not. Also opportunity - and trust me, had you guys gone at it, it would have been a circus in there. An unwanted circus on the part of the bar's management, I imagine.

Thing is, you got your penis sucked, and somehow- in some weird bizarro circumstance, managed to get PEP for it. It's as if you got PEP for kissing a stranger, or eating from the same utensil as a positive guy. I am flabbergasted that it's gone this far. And look at the posting history here. I don't flabbergast with ease.

Your PEP was about as necessary as my taking birth control before having sex with my (male, HIV negative) partner. It's like going through chemotherapy because you had grilled chicken, due to the carcinogen.

It's absurdity.

You have to get control over your feelings regarding HIV. You simply have to. I doubt that this forum is going to help much more than it has. It might even begin to hurt.

Logged

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Thanks for the message. I understand absolutely where you're coming from, but still find myself scared and nervous at time.

Update: I completed my PEP (Viread + Lamivudine) on May 29th, completing 28 days. I really had no bad side effects and found it to be somewhat tolerable. My HIV specialist told me to get an HIV test upon completion of PEP and then 3 months from date of exposure, NOT from the end of PEP. I see that a lot of the mods here suggest a test six weeks AFTER PEP, but given my exposure (receiving a blowjob) what would you say about this recommendation? I tested negative with an OraQuick rapid on Day 28 of PEP.

I was supposed to receive a viral load test (RNA) and a rapid test on the 14th, 16 days post PEP. The testing coordinator told me that those test results would be conclusive for this episode. What do you think?

I have sought psychological counseling and am on medication and seeing a therapist weekly. I was staying off the websites and was adjusting back into regular life, but I recently met someone and that has provoked my fears once more. He is a great guy but I am worried about being sexually active with him. I know my risk is super low and I don't want to scare him with unwarranted fears, but I would rather know I'm negative before we do. He had a test last a month ago and has only worn condoms for anal but has had unprotected oral sex.

I have some questions about some of what we have done:

1) Kissing. I've had some small cuts and burned my mouth recently. My lip was not bleeding drastically but it was red and I saw the cut but it was not actively bleeding (as far as I could tell). Is that a true risk? What about with sore throats?

2) We were masturbating in bed and I ejaculated on my stomach. He dabbed his finger in the semen and licked it. There was no oral sex. I was very worried and contacted my HIV doc who said it was 0 to no risk. Thoughts?

3) 48 hours ago he gave me unprotected oral sex. I do not precum and I did not ejaculate. Essentially he licked my testicles and shaft and only put his mouth on the head a few times for less than a minute total. Do I need to inform him of PEP? I know in order to transmit the virus, I'd have to *have* the virus, but I am worried.

4) I know ARS symptoms are not reliable, but for a few days I've had a sore throat. I get allergies and am wondering if it is air conditioning. Is it possible to experience ARS almost 6 weeks after an exposure, even with completing PEP? If PEP failed, wouldn't my rapid test at 4 weeks exposure be positive? I am worried because my guy has a rash on his body but his dermatologist says it is contact dermatitis. Of course, I am wondering if he is experiencing ARS. He is a bit of a hypo too and told me he googled his rash and found HIV symptoms. But his derm said otherwise...(don't know if she'd think about HIV though)

I know a lot of my fears are unwarranted. I just don't want to mess up what could be a good relationship by telling him about my unwarranted, low risk fears and freaking him out. He essentially has the same risk as me- he's had unprotected oral sex receiving and giving. Do I have a moral obligation to talk to him about this?

(I'm also 100% aware that a lot of this sounds nuts and I tried to refrain from posting. This is the first setback I've had in a while, but I am making slow progress and doing what I can to resolve my fears in healthy ways...)

Chuxtable , YOU ARE HIV NEGATIVE . If you had a risk and chose PEP , then the testing window period is extended and you would need to wait 6 weeks post pep to test and again at 3 months to confirm your results . You never had a risk so your last HIV test is conclusive , you do not have HIV .

HIV is acquired sexually from unprotected vaginal and anal sex , period . It also can be contracted by sharing drug injection equipment .

Your convoluted post about exposing someone to HIV that you are not infected with has left me with little choice but to issue you a warning . You need to be discussing this with your therapist , so if you come back asking questions you already have the answers to you will be given a 7 day time out .

Wow. You got a blowjob. Not one single person has EVER been infected through getting their dick sucked in the 30+ years of this pandemic. You're not going to be the first.

You never needed PEP. You never needed testing over a blowjob.

You DO, however, need to keep working with your therapist. Maybe more than once a week.

My esteemed colleague meant to say that if you continue to post this ludicrous stuff about your fears of being infected through a NO HIV RISK blowjob, that you will be given a 28 day time out, not seven.

If you read the Welcome Thread before posting like you're supposed to, you will have read the following posting guideline:

Quote

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.

It matters not that you took out a subscription. The rules still apply.

Please consider yourself warned!

Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

ALTHOUGH YOU DO NOT NEED TO TEST FOR HIV SPECIFICALLY OVER GETTING YOUR DICK SUCKED, anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I've remained HIV negative since my last post a few months ago. You may recall that I decided to go on PEP after receiving a blowjob from someone undetectable poz. I realize now how crazy that was, and regret that choice. However, I have felt paranoid about sex since then and constantly question every encounter. The logical route would be not to have sex if I can't handle it, I get that. I've been trying. I used to never have these issues until I heard about PEP, and now I find myself wondering if I should take it before my 72 hours after an encounter are up.

Saturday night I went out with friends drinking for my birthday. I met a nice guy at a bar and we went home together. I was quite intoxicated, so the details are blurry. I was penetrated and it hurt quite a lot so it didn't last too long. Then he came on me. The next morning, we had sex again, sober [mostly sober], and he used a condom. He, again, came on my chest. I was nervous about the condom usage of the night before. I told him I had tested negative a few weeks ago. He said he last tested two weeks ago, and that he plays safe. He said he "doesn't f### around with that sh#t" after a scary encounter a few months ago. He said we used condoms.

After that I felt fine and went home until later I started to question it. I don't know him, he is a stranger, though was very nice and down to earth. I know that doesn't mean shit and he could be lying. However, I don't know why we would use a condom for sex in the AM but not in the night [he wasn't as drunk as me, I suppose]. I also straight up asked him about it, and told him I've never had unprotected anal, etc.

I'm worried about the situation, since I bottomed, and if it was unprotected, that is the riskiest form of sex. I have some PEP and am wondering if I should use it as a precaution. Last time I tried taking it, the AZT really made me sick.

My questions:

1) From this scenario, would you take PEP in case this guy was lying?

2) What is the general risk scenario of bottoming without a condom and getting HIV without ejaculation?

3) I have AZT, Viread, and Lamivudine. My doctor said last time that Viread and Lamivudine would be more than enough, since studies showed 3 drugs weren't necessarily more effective than 2. But I also had had unprotected oral receiving, so not sure if he meant for my more limited exposure. Would I need all 3 to effectively take PEP?

This was essentially Sunday at 5 AM, so I am approaching the 42 hour point. What are your thoughts? I do have diagnosed OCD and anxiety and am on medications for them and have a therapist, but also don't want to play with fire. I live in NYC with a high percentage of HIV in the MSM population.

Jeff- Sorry, I didn't realize I had to continue posting in the same thread.

I guess no one can really tell me what happened except for myself. And this guy seems legit and kind, but I'm just worried, and if I can protect myself with PEP beforehand then I'd prefer to.

Could you please just answer my questions?

What are chances of brief unprotected anal sex as a bottom with no ejaculation? It must have lasted a few minutes, but it hurt too much for him to keep it inside there long. The next morning I know we used a condom, so I'm not worried about that.

A doc in NYC I know is a big infectious disease specialist. He said Viread and Epivir make up Truvada. So theoretically that would be a sufficient PEP regimen like Truvada is, correct?

We don't give odds on HIV transmissions . You said you had protected sex and this is another example of your anxiety getting the better of you .

You have been given the facts already and there is really nothing more we can do for you other than say if you had a risk then you need to test at the appropriate time .

If you feel you had a risk the appropriate time to test is 6 weeks past any possible exposure and again at 3 months to confirm the results .

You do not need to be prescribing PEP to yourself and need to see a doctor . You must first have an HIV test and its possible your doctor might want to check your liver and kidneys . We will not hold your hand every time you have sex and it makes no difference if you purchase a subscription . Please get the help you need for your HIV phobia or you can look forward to this kind of drama every time you have sex , end the cycle and discuss this with your doctor , not us .

Jeff. Fair enough. I honestly think I am just being insanely paranoid about the situation when I have no reason not to trust this guy. I've called my therapist to schedule an appointment, and I've stopped the PEP.

Quick update. I talked to an Infectious Disease specialist at Mt. Sinai (I'm in NYC) and told him what happened. He suggested I continue with the PEP. I'm disappointed to hear this, especially since I was attributing all of the anxiety about it to my mental health problems and not the factual nature of the situation. I don't have the contact details for the guy I slept with, though I am trying to get them from a mutual friend. The ID at the hospital said that even a standard antibody test wouldn't be enough to prove he's negative; a viral load would be the only way to stop the PEP.

I'm a bit nervous because I took PEP earlier for something totally ridiculous. And now the docs are actually telling me to take it? I'm trying not to stress out. I have no problems with the Viread and Lamivudine, but the AZT causes me to vomit in the morning. I'm also heading out of the country for my final week of PEP...

I started PEP at 42 hours and missed a dose, that I took again at 72 hours. Have you seen anyone seroconvert post-PEP? I know the earlier, the better. Again, my risk was potentially unprotected anal sex (the guy said we used protection) without ejaculation that didn't last too long. Any suggestions on how to handle AZT, too? Hoping to come out of this okay. Thanks all...

You did initially say that the guy used a condom and you also shared that you discussed it with him and have no reason to doubt a condom was used .

There isn't a thing I can say to you at this point that can help you . I suggest you follow your doctors advice since you have repeatedly ignored ours .

Please have these discussions with your healthcare providers from now on , we simply cannot help you . Continuing this type of discussion is enabling your phobia and we do not want to be a part of that . I'm going to give you one last opportunity to stop this and seek help outside of this forum . If you came back with more of the same I will have no choice other than to give you a time out .

I'm wondering what advice you'd have for my particular situation. I drank to excess a few evenings ago and ended up topping another guy at a bar. I don't know this person. I was pretty drunk but seem to remember it lasting about 4 strokes. Afterwards I immediately stopped, knowing that unprotected anal and vaginal sex are the most risky for HIV. Being inebriated, I don't know if there was any blood or what lube we used for that matter.

I presented at a local LGBTI health community clinic the next morning for PEP. The Physician's Assistant told me it was a very low risk situation, but she would prescribe me PEP if I wanted it anyway if I could pay. They have a program with Gilead for Stribild, but I was unable to obtain that, so they gave me Truvada alone as PEP.

I began my Truvada about 8 hours after exposure and have been taking it diligently. While I've read the science is on my side, I am mostly disappointed in myself for engaging in this behavior in the first place-- I've never not used a condom. In fact, I'm usually absolutely paranoid. Being versatile, I bottomed for a guy the other night. We used condoms, I felt the condom on his penis even in the dark and when we finished he said he took it off, but after I was very paranoid maybe he was lying to me or it broke and I didn't know (though condom breaks are apparently quite noticeable.)

The paranoia/fear of HIV that many of us feel tends to lead to anxiety and shame and thus more risk taking behavior as a result to alleviate that. That being said, I will be resuming my therapy to help manage my OCD and anxiety in addition to figuring out why I did what I did. It's a pretty vicious cycle.

My questions

1) Is Truvada sufficient for PEP in this encounter? The Physician's Assistant and pharmacist on site who prescribe PEP and PrEP in this sitting regularly say so due to the lower risk. I've read conflicting info between docs and experts on thebody and freedomhealth about Truvada being provided alone.

2) I'm not exactly sure what I used for lube. It was a few quick strokes. I don't recall ejaculating inside of him. If this individual had been letting other guys top him, too, and their semen was the lubrication, does this change the risk scenario? I am attempting not to delve to far into the "what if" territory.

3) What would the mods say is my risk given what I've stated above? This happened in Chicago, if that's any help in terms of stats and populations.

I'm so deeply ashamed this happened and hope to come out of it with the same negative status as before.

I should also mention I am cut and was recently tested for STIs including Hepatitis in April. At the clinic they ran an HIV test (negative) and again did a full lab for STI tests I'll receive the results from in a few week. My year of last sexual encounters have been with condoms and unprotected oral sex.

1 . Pep is not recommend for the insertive partner for condom breaks or brief insertions but to answer your question ... truvada is sufficient as PEP when used alone .

2 . We do not answer what ifs . You had a risk for HIV and since you are now on PEP you can expect a negative results when you test at 6 weeks past your last dose and any possible exposure and again at 3 months to confirm the results .

3. You had a low level risk and will need to test in the window period I gave you .

I've noticed that since the release of guidelines for Truvada as PrEP, some (referring here to the doctors and experts at thebody) say that Truvada alone is not sufficient as PEP any longer.

I thought the only landmark study re: PEP was with AZT and occupational exposures, and that essentially no one really knows for certain what drug combo works best for PEP. Hence different guidelines all over the world. Sometimes a 3 drug regimen is suggested, but not always. Truvada is a 2 drug regimen. That makes sense for a lower risk such as mine.

Do we not have more information available on Truvada as PEP over Truvada as PrEP? To my knowledge, there are a few studies re: PrEP, and as a result still a lot of debate about long term usage, etc. If PrEP is essentially acting as PEP all of the time (minus that you constantly have levels of meds in your blood at times of constant exposure as opposed to having an exposure and then a few hours later getting the meds in your blood), I wonder how we can draw conclusions at this time that Truvada cannot be used as PEP alone?

I've noticed that thebody is quite conservative and borderline fear mongering at times. I'm on Day 8 of Truvada after my exposure and obviously cannot ask for another drug, but I am trusting my doc and pharmacist who dole out HIV meds for PEP and PrEP everyday over thebody. I'm just wondering if you can elaborate on why they say Truvada only is useless? Dr. Wohl at thebody called a brief unprotected anal insertive act a high risk scenario when everyone else has dubbed it low.

I've noticed that since the release of guidelines for Truvada as PrEP, some (referring here to the doctors and experts at thebody) say that Truvada alone is not sufficient as PEP any longer.

I thought the only landmark study re: PEP was with AZT and occupational exposures, and that essentially no one really knows for certain what drug combo works best for PEP. Hence different guidelines all over the world. Sometimes a 3 drug regimen is suggested, but not always. Truvada is a 2 drug regimen. That makes sense for a lower risk such as mine.

Do we not have more information available on Truvada as PEP over Truvada as PrEP? To my knowledge, there are a few studies re: PrEP, and as a result still a lot of debate about long term usage, etc. If PrEP is essentially acting as PEP all of the time (minus that you constantly have levels of meds in your blood at times of constant exposure as opposed to having an exposure and then a few hours later getting the meds in your blood), I wonder how we can draw conclusions at this time that Truvada cannot be used as PEP alone?

I've noticed that thebody is quite conservative and borderline fear mongering at times. I'm on Day 8 of Truvada after my exposure and obviously cannot ask for another drug, but I am trusting my doc and pharmacist who dole out HIV meds for PEP and PrEP everyday over thebody. I'm just wondering if you can elaborate on why they say Truvada only is useless? Dr. Wohl at thebody called a brief unprotected anal insertive act a high risk scenario when everyone else has dubbed it low.

Thanks again for your words.

We aren't responsible for incorrect information that your have received elsewhere. Truvada is the drug of choice for PrEP.

Truvada is a powerful combo of two meds in one, tenofovir and emtricitabine .

You indicated that this was the only option you had due to the expense and it is effective although doctors often combine it with another med you can count on coming out of this OK because condom breaks rarely results in the transmission of HIV for the insertive partner and I have never seen a case where Truvada alone as pep failed.

I'll also note I came back negative for all STI's, have regular kidney and liver function, and had a rapid test done on the spot when I presented for PEP and a viral load taken, so I was HIV neg at the time of PEP. And am vaccinated for Hep A and B.